VECTURA INHALERS
The Vectura website states that their “combination of formulation
science, device technology and inhaled development expertise has
contributed to the success of 13 inhaled medicines, launched by our
partners and licensees. Since launch, they have generated $11 billion
in sales and in 2020 these products were used by 10 million patients
worldwide .”7 The products are set out in Table 1 and
Figure 1, based on the Vectura Group plc Annual Report and Accounts
2020.8 The Vectura accounts report revenue income in
2020 for Flutiform, royalty and other marketed revenues for the GSK
Ellipta, Novartis Breezhaler, Hikma generic Advair programme, and Sandoz
Forspiro.
Data from the NHS Business Services Authority
(https://www.nhsbsa.nhs.uk/statistical-collections/prescription-cost-analysis-england/prescription-cost-analysis-england-202021)
show that in 2020, English primary care spend on inhalers totalled
£960.5 million. The Vectura products listed equate to £177 million -
almost a fifth of total inhaler expenditure.
Fortunately, over 120 inhaled products are now licensed for the
treatment of asthma and COPD in the UK, so there are likely to be
several suitable alternatives for patients that healthcare professionals
can prescribe, to avoid directing income to the tobacco industry if the
takeover goes ahead. Some examples are set out in Table 2.
Inevitably, a change in prescribing policy will require switching some
individuals to alternative preparations and different inhaler devices.
It may also require a change in the inhaled drug(s) to different ones in
the same class. It is important therefore, that proposed changes are
performed in collaboration with each patient as a partner, using the
principles of shared decision making9. Changes in
inhaled therapy will require careful discussion with patients about the
reasons for such a change, potential available options and their
agreement to switch.
In order to ensure that asthma and COPD control is optimised, it is
essential that inhaler technique is taught and checked, before an
alternative is prescribed. An assessment of each patient’s inspiratory
capacity to use either a dry powder inhaler or an aerosol device (pMDI,
breath-actuated pMDI or soft mist inhaler) should be made to determine
the most appropriate type of device to prescribe.10The use of low carbon inhaler devices may be prioritised in patients
able to use dry powder or soft mist inhalers, but if not, then pMDIs
should be used.
Table 1. Current approved inhaled medicines developed in
partnership with Vectura